Migraines and Other Headaches

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Migraines and Other Headaches

Natural Relief for Real Pain

What women have suspected for years has been confirmed: Headaches really are worse for women than they are for men.

What is it about women's headaches that make them feel so intense and sometimes even disabling?

The answer may be estrogen. Changes in estrogen levels that govern the ebb and flow of women's menstrual cycles can cause headaches. Headache-prone women have more of them during menstruation and ovulation; then, headaches last longer and are more intense and, worse yet, are harder to treat, harder to prevent and harder to eradicate once they've begun.

In addition to hormonal changes, headaches can be caused by triggers that are as individual as women are. Joan Miller, Ph.D., a clinical psychologist in Marietta, Georgia, and author of Headaches: The Answer Book, cites several common provokers. They include tension, certain foods (such as lunchmeats or aged cheese), caffeine withdrawal, skipping meals, environmental factors (pollen or pollution, for example) and certain physical causes, like problems associated with sinuses, vision, teeth, fevers or head trauma.

HEADACHES AND SUPER-HEADACHES

The two major headache syndromes that affect women are migraine and tension (or muscle contraction) headaches. What's the difference? According to Patricia Solbach, Ph.D., a headache specialist and director of the Center for Clinical Research at the Menninger Clinic in Topeka, Kansas, the pain of tension headaches is most commonly experienced as a steady, uncomfortable background pressure that doesn't disable you to the point of dysfunction. Migraines, she says, feel much worse: intense, throbbing pain sometimes accompanied by nausea, vomiting and sensitivity to light and sound. Migraines can last a few hours or even a few days.

What Women Doctors Do Cues Herself to Relax Patricia Solbach, Ph.D. Headache specialist Patricia Solbach, Ph.D., had gotten only the occasional headache until she was fresh out of graduate school. Now director of the Center for Clinical Research at the Menninger Clinic in Topeka, Kansas, she recalls: "I had just landed a great job coordinating a $250,000 research grant for--ironically enough--the study of nondrug headache treatments. I had steady headache pain daily, with tremendous pressure in my eyes and temples. It was awful. I couldn't think, much less work very well. There I was, a headache specialist, and I had to find out the hard way that too much stress could cause headache pain. So I learned how to relax, and I learned some antiheadache strategies that helped relieve the pain. "Don't wait for a headache to build. At the very first sign of a headache, cue your body to relax by taking a break and sipping a cup of herbal tea," she says. "This works by breaking the tension that causes headaches." Over the years Dr. Solbach's responsibilities at the Menninger Clinic increased. But happily, she reports, her headaches did not. Now, if she gets one headache a month, it's a lot.

About 5 to 10 percent of women who get migraines will experience auras, which are sensations of bright, even colorful, lights that appear before the eyes prior to the onset of a migraine headache.

ALL-PURPOSE OPTIONS

There is no shortage of headache relief medicines on the market. And painkillers have their place. "Take acetaminophen, aspirin or ibuprofen according to package directions at the first sign of a headache," says Michelle Cyr, M.D., associate professor of medicine at Brown University School of Medicine and director of the Division of General Internal Medicine at Rhode Island Hospital, both in Providence. "You can often nip it in the bud."

But then again, if headache relief were that simple, you wouldn't be reading this chapter. Or perhaps you're interested in a nondrug approach. If you have a headache right now, the tips that follow will help you feel better fast. Some will work for tension headaches, others may help your migraines and some just might help you prevent your next headache, whichever kind it is. Women doctors agree that it's a good idea to experiment: Headache remedies work differently for different headaches, for different women, at different times.

Thumbs up, pain down. "Place your thumbs right in the center of each temple," says Dr. Solbach, who sometimes gets headaches herself. "Massage firmly using a circular motion for a minute or two, or until you feel relief. If I catch it early enough, I find that I can sometimes stop a headache."

Take a hot bath or shower. "This may further help your muscles relax," says Dr. Miller.

Visualize away your headache. "Imagine that your headache pain is caused by a rope that's knotted and wrapped tightly around your head," suggests Dr. Solbach. "Then concentrate hard on seeing it unknot, inch by inch. Watch as it slowly loosens and falls away from your head."

Try necking with a heating pad. "When you have a stiff neck, you can get a headache, because the stiff muscles hurt and cause pain that can be felt in your head," says Mary Scholz, R.N., a nurse clinician and nurse manager of Headache Associates at Faulkner Hospital in Boston. Her remedy? Apply a heating pad to the back of your neck to soothe the stiffness.

Ice a migraine. "For easing migraines, ice usually works better than heat," says Dr. Solbach, "most likely because of its action as a vasoconstrictor--it shrinks blood vessels pressing on nerve endings." A resealable plastic bag full of ice, wrapped in a kitchen towel, works.

Feverfew for you? For occasional headaches, Sandra McLanahan, M.D., executive medical director of the Integral Health Center in Buckingham, Virginia, recommends taking the herb feverfew. "Research on feverfew suggests that it can be effective as a headache remedy; I've used it with success for patients with headaches. I recommend taking two feverfew capsules (available at health food stores) three times a day until your headache is gone." Studies indicate that feverfew has anti-inflammatory properties, which is why it might be particularly effective for migraine headaches.

Lie down in a dark room. "If you have migraines," says Dr. Cyr, "lying down in a darkened room and napping for an hour or so can usually make the headache history."

Have a snack. "You can get headaches from just being hungry," says Dr. Miller, because your blood sugar drops.

"Always be aware of when you last ate," adds Julie Buring, Sc.D., as sociate professor of ambulatory care and prevention at Harvard Medical School and an epidemiologist at Brigham and Women's Hospital in Boston. "Try eating smaller meals, spread more frequently throughout the day."

When To See A Doctor "Three hundred different medical conditions can cause headaches," says Patricia Solbach, Ph.D., a headache specialist and director of the Center for Clinical Research at the Menninger Clinic in Topeka, Kansas. "Most are tension headaches, and the rest are migraines and don't constitute emergencies." However, she cautions, "If you're experiencing the worst headache that you ever had, see your doctor right away." The following symptoms could signal a serious condition that needs prompt medical attention. * Confusion * Numbness * Vision problems * More-severe-than-usual headache, if you're over 50 * Chronic headaches that worsen Also, talk to your doctor if you're on the Pill and get migraines--the estrogen in oral contraceptives can exacerbate migraines.

Take a coffee break. "If you feel a migraine coming on, go someplace quiet and have a strong cup of coffee. Take aspirin or ibuprofen according to package instructions," says Dr. Solbach. Like ice, caffeine acts as a vasoconstrictor, which seems to help migraines.

Or, do the caffeine wean. The surprising thing about caffeine is that either too much or lack of it can trigger pain. According to Dr. Miller, too much caffeine can lead to headaches, because of an increase in tension or a decrease in sleep (or both). Consuming less than the usual amount of caffeine can lead to very painful withdrawal headaches. "Frequently, weekday coffee or cola drinkers may drink less on weekends, and they get fierce withdrawal headaches." Dr. Miller recommends that if you get headaches, give up caffeinated drinks slowly and gradually--by four to six ounces a day--perhaps by diluting regular brew with decaf until you're finally caffeine-free. She also suggests substituting eight cups a day of noncaffeinated liquids, such as water, juices, skim milk or herbal teas.

Keep a headache diary. "Both tension and migraine headaches can have triggers," says Dr. Cyr. "Your monthly cycle can affect headaches, too." She suggests that you log the time of day and month, the foods, activities, moods--anything that could possibly trigger a headache. After a couple of weeks, read your diary. See if anything obvious is causing your headaches and avoid the source if you possibly can.

"It's a very individual thing," says Dr. Buring. "For many, chocolate can be a migraine trigger--though it doesn't trigger my migraines--but red wine will immediately send me right around the bend."

Avoid migraine triggers. Dr. Cyr recommends avoiding the most common offenders: that is, foods that have been aged, fermented, pickled or marinated. Other reputed problem foods are those containing monosodium glutamate, or MSG (such as canned soups), nitrates or nitrites (such as lunchmeats).

ADDED HELP FOR KILLER MIGRAINES

Once a migraine takes hold, it's a bugger to relieve. So women doctors offer this additional advice for migraine sufferers in particular.

Restock your magnesium. An Italian study indicates that people with migraines are likely to have lower blood levels of magnesium than non-migraine-sufferers, and suggests that magnesium supplements for people with migraines warrant further study. Good food sources of magnesium include green leafy vegetables, legumes, seafood, nuts and whole grains.

Regulate sleep patterns. "People who work irregular shifts have trouble with their migraines," says Scholz. "Circadian rhythms seem to play a part in migraines. Try to get to sleep and wake up at the same times each day and don't sleep late on weekends." Also, avoid napping during the day, as this may change your circadian rhythms.

Give aspirin a chance. An aspirin a day may keep migraines away, suggests Dr. Buring. She conducted a study using low doses of aspirin regularly to prevent migraines. "The problem with some of the prescription drugs used to try and prevent migraines (like beta and calcium channel blockers, antidepressants and mood-regulating drugs) is that they are like hitting a little problem with an awfully big hammer," she explains. "In our study we found that taking a regular 325-milligram aspirin tablet every other day, regularly, cut repeat migraine attacks by 20 percent. It might not work for everyone, but it's definitely worth trying, because if it works, it's an easy, inexpensive and relatively safe solution."